Provider Demographics
NPI:1962445767
Name:ARTURO RODRIGUEZ-MARTIN MD PL
Entity Type:Organization
Organization Name:ARTURO RODRIGUEZ-MARTIN MD PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ-MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PL
Authorized Official - Phone:941-613-1356
Mailing Address - Street 1:PO BOX 496016
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33949-6016
Mailing Address - Country:US
Mailing Address - Phone:941-625-1275
Mailing Address - Fax:941-625-1286
Practice Address - Street 1:22099 ELMIRA BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-7018
Practice Address - Country:US
Practice Address - Phone:941-613-1356
Practice Address - Fax:941-613-1591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79916207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35441AMedicare PIN
FLH15455Medicare UPIN
FLK6262Medicare ID - Type UnspecifiedGROUP ID